Provider Demographics
NPI:1073233953
Name:NOEL, AMY LYNN
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:LYNN
Last Name:NOEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 S ORCHARD LN
Mailing Address - Street 2:
Mailing Address - City:NEW LONDON
Mailing Address - State:IA
Mailing Address - Zip Code:52645-1408
Mailing Address - Country:US
Mailing Address - Phone:310-759-7197
Mailing Address - Fax:
Practice Address - Street 1:401 S BIRCH ST
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:IA
Practice Address - Zip Code:52623-9613
Practice Address - Country:US
Practice Address - Phone:319-392-4259
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-31
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant